IDEAS home Printed from
   My bibliography  Save this paper

The cornerstone of Labour's 'New NHS': reforming primary care


  • Karen Bloor

    () (Centre for Health Economics, The University of York)

  • Alan Maynard

    () (Centre for Health Economics, The University of York)

  • Andrew Street

    () (Centre for Health Economics, The University of York)


Two remarkable aspects of the Thatcher ‘internal market’ reforms of the NHS were the focus on creating a market for hospital services and the way in which primary care was treated almost peripherally in the 1989 White Paper (Department of Health 1989a). The 1991 NHS reforms introduced general practitioner (GP) fundholding almost as an afterthought, and the revision of the GP contract in 1990 Paper (Department of Health 1989b) was conducted separately from the implementation of other health care reforms. In contrast the principal focus of Labour’s ‘new NHS’ reform is primary care (Department of Health 1997). The intention of the government is both to improve the efficiency and equity of primary care provision and to develop Primary Care Groups and Primary Care Trusts which both provide care efficiently and act as agents who purchase secondary and tertiary care on behalf of patients. This is an ambitious agenda. This paper explores the policy context of Primary Care Groups in sections 1 and 2, describes and appraises the government proposals in section 3, and identifies major issues involved in the implementation of change in section 4.

Suggested Citation

  • Karen Bloor & Alan Maynard & Andrew Street, 1999. "The cornerstone of Labour's 'New NHS': reforming primary care," Working Papers 168chedp, Centre for Health Economics, University of York.
  • Handle: RePEc:chy:respap:168chedp

    Download full text from publisher

    File URL:
    File Function: First version, 1999
    Download Restriction: no

    References listed on IDEAS

    1. Given, Ruth S., 1996. "Economies of scale and scope as an explanation of merger and output diversification activities in the health maintenance organization industry," Journal of Health Economics, Elsevier, vol. 15(6), pages 685-713, December.
    2. Karen Bloor & Alan Maynard, 1993. "Expenditure on the NHS during and after the Thatcher years: its growth and utilisation," Working Papers 113chedp, Centre for Health Economics, University of York.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Adam Oliver, 2005. "The English National Health Service: 1979-2005," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 75-99.
    2. Giuliano Masiero, 2001. "Patient movements and practice attractiveness," Departmental Working Papers 2001-05, Department of Economics, Management and Quantitative Methods at Università degli Studi di Milano.

    More about this item


    fundholding; rationing;


    Access and download statistics


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:chy:respap:168chedp. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Gill Forder). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.